Stress at work: A pill or a peril?

You must have read a young techie died of heart attack while watching TV or a movie. Instead of discarding these as frivolous, have you wondered why this might have happened? Why young adults die so early? We all go to work to make a good living. Yet, can the work itself affect us? These questions have enthused many public health researchers like myself to study the effects of job stress.

Studies done in India indicate that nearly one third of middle-aged have high blood pressure. If untreated, high blood pressure can result in heart attacks or strokes in 10 years (together known as cardiovascular diseases, CVD). Sadly, not many will know that they have high blood pressure until a stroke or heart attack occurs.

Media reports of someone dying of a CVD represent the tip of an iceberg with lot more hidden population with high blood pressure. How many of them developed it due to job stress? 

A study published in “The Lancet”, indicated marginal risk of CVD at 3 per cent for people with high job stress. They inferred job stress poses very little risk compared to bigger killers such as smoking, obesity and physical inactivity. We hypothesised that it is very unlikely that job stress can directly cause CVDs. We wanted to know whether job stress increases the risk of high blood pressure, which further increases the risk of heart attack.

To answer, we carried out a comprehensive synthesis of all the available research
(meta analysis) of studies on this topic. We found that the people with high job stress are 24 per cent more likely to develop high blood pressure. Therefore, it is important to mitigate stressors at work to stay healthy. Job stress can also cause headaches, musculo-skeletal pains, anxiety etc.

Hans Selye famously said "It’s not stress that kills us, it is our reaction to it." Stress isn’t bad always and can be either good stress (“eustress”) or bad stress (“distress”). A small amount of stress is found to be productive in terms of furthering the career and making financial progress. People choose high stressed jobs to improve their quality of life. Separated by a thin line, whilst eustress can better the quality of life, distress can ruin it by causing diseases.

Stress can also be from events such as daily commute etc. Experiencing driving-related stressors can have secondary impact on the work, family and personal life too; increasing the conflicts and resulting in perpetual vicious cycle. As a result, although their parents are disease free, offsprings are increasingly experiencing high blood pressure very early in life.

Options for companies
Many companies cough up mammoth medical bills when their employees get sick due to CVDs. The earnest million-dollar question is, how do we change the current scenario? Companies have options, either by “treating” end of continuum CVDs and/or “preventing” start of the stream by reducing stressors and high blood pressure.

In order to have normal life expectancy, healthy workers need to be prevented from getting it and those who have high blood pressure should be treated well including lifestyle modifications.

On the contrary, many companies resort to only the first option of “treating”, for its apparent simplicity of tying up with insurance companies and hospitals. Less they realise, it leads to spending several billions over next few decades and humongous losses in trained workforce. It might take some effort in short term, the second option of “prevention” will provide incremental long-term benefits in productivity and overall reductions in costs. 

The stressors at workplace are relatively easier to mitigate compared to other sources of stress.  The companies can either choose to shell out colossal medical bills for devastating illness or to spend comparatively meagre money on simple yet effective prevention measures. In our study, we found greater proportion of MNCs in India offering relatively more flexible, stress free and healthier work environment.

If Indian companies have to compete globally and attract the best workforce, it is imperative to provide work-life balance at par with the MNCs. This can happen only when Indian companies go beyond their interests alone and start excelling in taking care of employees. 

The mantra of “Make in India” will materialise into reality, only if, the managements will start caring more about people who “work in India”. Pending this gigantic shift in stance, employees have little choices despite adopting better mechanisms to handle stress.

(The writer is Additional Professor at Indian Institute of Public Health, Bengaluru)